Long-term safety and efficacy of nalmefene in Japanese patients with alcohol dependence

Psychiatry Clin Neurosci. 2020 Aug;74(8):431-438. doi: 10.1111/pcn.13017. Epub 2020 May 27.

Abstract

Aim: The safety and efficacy of nalmefene in Japanese patients with high or very high World Health Organization drinking risk level of alcohol dependence were assessed in a multicenter, randomized, double-blind, placebo-controlled, phase 3 (lead-in) study. Here, the long-term safety and efficacy of nalmefene in an open-label extension of the lead-in study are presented.

Methods: Patients who completed the 24-week lead-in study were eligible for the extension study, where they were treated with nalmefene 20 mg as needed for 24 weeks. The long-term safety and efficacy of nalmefene 20 mg during the total 48-week period were evaluated. Treatment-emergent adverse events during the study period were recorded and change from baseline in the number of heavy drinking days and total alcohol consumption were calculated.

Results: Overall, long-term nalmefene 20 mg was well tolerated; the main treatment-emergent adverse events reported in ≥5% of patients included nasopharyngitis (37.2%), nausea (36.5%), somnolence (21.2%), dizziness (16.8%), malaise (14.6%), and vomiting (12.4%). The number of heavy drinking days and total alcohol consumption decreased from baseline to 48 weeks (mixed model for repeated measures, least squares mean ± standard error, -15.09 ± 0.77 days/month and -53.20 ± 2.29 g/day, respectively) during the study.

Conclusion: This long-term evaluation in Japanese patients with high or very high drinking risk levels of alcohol dependence indicated that nalmefene was safe, well tolerated, and efficacious.

Keywords: alcohol dependence; drinking behavior; drug therapy; opioid; safety.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Alcohol Drinking / drug therapy*
  • Alcoholism / drug therapy*
  • Double-Blind Method
  • Female
  • Humans
  • Japan
  • Male
  • Middle Aged
  • Naltrexone / administration & dosage
  • Naltrexone / adverse effects
  • Naltrexone / analogs & derivatives*
  • Naltrexone / pharmacology
  • Narcotic Antagonists / administration & dosage
  • Narcotic Antagonists / adverse effects
  • Narcotic Antagonists / pharmacology*
  • Outcome Assessment, Health Care*
  • Time Factors

Substances

  • Narcotic Antagonists
  • Naltrexone
  • nalmefene